The Push to End Chronic Homelessness Is Working

Sometime in June, the 100,000 Homes Campaign — an initiative launched four years ago to help communities around the country place 100,000 chronically homeless people into permanent supportive housing — expects to announce that it has reached its goal. It’s a significant milestone: It means that many American cities are currently on track to end chronic and veteran homelessness by the end of the decade or earlier.

The campaign, which is coordinated by Community Solutions and works in partnership with the Department of Housing and Urban Development, the Department of Veterans Affairs and the United States Interagency Council on Homelessness, has helped to shift the way homeless organizations and agencies around the country set goals, measure progress, prioritize individuals and coordinate their efforts to house people living on the streets.

Consider Jacksonville, Fla. In 2011, when the city began engaging with the 100,000 Homes Campaign, 3,025 of its residents were homeless and 1,104 were chronically homeless. Earlier this year, the city reported that the number of homeless residents had dropped to 2,049, with 399 of them chronically homeless, according to Shannon Nazworth, the executive director of Ability Housing of Northeast Florida. That’s a drop of one-third and two-thirds, respectively.
Something similar occurred in Nashville. In June 2013, galvanized by the 100,000 Homes Campaign, the city launched How’s Nashville, a concerted effort to end chronic homelessness by the end of the decade. The city started tracking its monthly placements. Previously, it had been averaging 19 per month; today, it’s housing an average of 47 per month, reports Will Connelly, who directs the city’s Metropolitan Homelessness Commission. Since last June, Connelly said, the city has placed more than 500 chronically homeless people in permanent supportive housing.

Many other cities have ramped up their placements over the past year or two. The campaign tracks more than 50 cities that have been housing at least 2.5 percent of their chronically homeless population for three consecutive months, a pace that correlates with ending chronic homelessness in four or five years. (Nationally, from 2010 to 2013, chronic homelessness declined by 16 percent, and homelessness among veterans declined by 24 percent.)

How did these changes happen?

When I first reported on the 100,000 Homes Campaign in December 2010, it struck me as an audacious vision: the human welfare equivalent of the race to put a man on the moon. Was it achievable?

The approach was backed up by evidence and experience. The Housing First model advocated by the campaign — identify the most vulnerable people on the streets and get them into permanent supportive housing as quickly as possible — had proven to be an effective solution for chronically homeless people, those who had been living on the streets for extended or repeated periods and who, in many cases, had a mental disability, a physical illness, a drug or alcohol addiction, or a combination of the three. (For homeless families and youth, and for individuals with less acute needs, different kinds of assistance may be more appropriate.)

Campaign leaders had led efforts in a few dozen communities. They had developed a kind of blueprint: Mobilize volunteers to get to know homeless people by name and need in the wee morning hours, prioritize certain homeless people based on a “vulnerability index,” bring housing advocates and agency representatives together to streamline the placement processes, and share ideas about how to cut through red tape. It worked. The question was: Could these innovations take root in cities across the country? Would communities adopt them? Would they be able to make headway even with profound shortages of affordable housing?

In January 2012, things weren’t looking so good. “We looked at our numbers and we realized we were on track to be the 30,000 homes campaign,” recalled Becky Kanis Margiotta, the campaign director.

At the outset, Kanis and her colleagues had imagined that once people saw what was working, policies and behavior change would follow. But that didn’t happen. It would take a more deliberate push, they realized.

A deeper problem was that even engaged communities were setting modest and sometimes arbitrary goals, doing little to track results, and neglecting to use data to drive improvements. “Just having good intentions and housing people doesn’t put you on track to end homelessness,” said Beth Sandor, the campaign’s director for quality improvement. “If you can’t tell us today how many people you need to house to get to zero, how can you get to zero?”

In 2010, the federal government’s Interagency Council on Homelessness had issued a national plan, Opening Doors, which called for an end to chronic homelessness and homelessness among veterans by 2015 and an end to homelessness for families, youth and children by 2020. As is common with national plans, many communities hadn’t taken ownership for their piece of the goal. And few had taken steps to see what they might be able to achieve if they really went for it.

For Kanis, who had graduated from West Point and served for nine years as an officer in the United States Army, goals had to be broken down and progress carefully monitored. “In January 2012, the average community in the campaign was housing 1.6 percent of their chronically homeless population each month,” she said. “We saw that if we were going to meet the goal, we needed to enroll three more communities each month and we needed to help each of them go from housing 1.6 percent to housing at least 2.5 percent of their chronic homeless population each month.”

That’s exactly what they set out to do. Kanis and her colleagues called up every community partner and explained the need to move faster and to collect actionable data to move toward the national goal. Some backed off the challenge, others were excited. Campaign staffers had developed a Housing Placement Boot Camp process, in which representatives of housing and social service agencies, and other organizations, would come together to redesign housing placement processes, shaving weeks or months off them. The campaign began partnering with the Rapid Results Institute, a group whose methodology challenges teams to come up with bold goals that they commit to achieving within 100 days. (My colleague Tina Rosenberg has reported on this model.)

They focused on building enthusiasm, too, and eliciting creativity – sending out awards (statues of roosters!) to people around the country who had demonstrated pluck or creative rule breaking. “A lot of our job has been eliminating fear,” said Kanis. “The great unleashing that happens when you let go of control mechanisms and let people improvise their own solutions.”

In Jacksonville, in the year before 2013, the city had been housing two to nine chronically homeless individuals each month. That spring, representatives from the city’s housing agencies and local social service organizations participated in a Boot Camp that had been organized in conjunction with Veterans Affairs and HUD.

“It made us go beyond our normal boundaries,” recalled Shannon Nazworth, whose organization, Ability Housing, has served as a hub for the local housing campaign. “We had to think, What could we do in the next 100 days?” They established a goal to house 100 vulnerable people in 100 days; it meant increasing their average placement rate from 4 people per month to close to 40 per month. “We set this goal and, candidly, people didn’t think we could pull it off,” said Nazworth.

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Kerry Morrison of the Hollywood Business Improvement District surveyed a man experiencing homelessness.Credit Rudy Salinas, PATH

They connected with other communities to learn how they had sped things up. They started instituting biweekly conference calls across agencies, and collecting data, talking through individual cases, sharing information, solving one problem after another. Is there a way to process HUD-VASH vouchers more quickly? Could the local housing authority modify its eligibility for some of its single room occupancy units? Could it amend the screening criteria to allow persons with certain misdemeanor arrests to be eligible for housing? Could some of the steps in the process be skipped or handled simultaneously?

“We ended up exceeding the first goal,” said Nazworth. “So we set a goal to do another 100, and we ended up beating that goal, too.” They more than doubled it. “The successes made people in the community think, Wow, we can actually move the bar on this. We can end long-term homelessness.”

In Nashville, the process unfolded similarly, recalled Will Connelly: “We had a lot of great agencies and nonprofits in Nashville working on housing, but not always moving in the same direction or setting goals together. So we came together around a shared goal and we defined what each organization was going to do.”

“[The campaign] taught us how to clarify the demand for housing, line up supply, and inspire our community to disrupt the status quo,” he added. It also revealed broad community support. “During the launch of How’s Nashville, we asked Nashvillians to donate $1,000 to cover the move-in costs (security deposit, first-month’s rent, utility deposit, furniture, etc.) for one household,” Connelly added. “In 11 months, over $120,000 was donated in amounts ranging from $10 to $15,000. This amount was raised without a formal fund-raising campaign and all donations were in the form of paper checks that came through the mail.”

We’re accustomed to hearing about our social service systems when they fail. But when progress is being made on an issue as difficult as chronic homelessness, it’s vital to understand how the gains were achieved. “If Community Solutions had been around 10 years ago, our country would be much closer to ending chronic homelessness, and I would be looking for a job in another field,” said Will Connelly.

“The campaign has been uniquely positioned and valuable in building energy locally on the ground and working with us to equip communities with the tools that they need to do this work,” said Laura Green Zeilinger, the executive director of the United States Interagency Council on Homelessness, which has worked closely with Community Solutions. “The progress that we’re making on veterans” — and chronic homelessness — “comes from the fact that we’ve invested in the things we know work. And when we strategically implement with those solutions, we’re seeing the result.”

Below are five key lessons from the campaign:

Gather good data and use it for improvement every day. It’s crucial to break big goals down into small steps and track progress on a continuing basis, so systems can be continually adjusted and improved. The idea of coming up with a policy, rolling it out on a large scale and, after several years, conducting a major evaluation to see if it worked — is like a baseball team playing five seasons and discovering after 810 games that they need better pitching. It’s much better to learn as you go.

Get to know the people behind the numbers. One of the key insights from the 100,000 Homes Campaign is the humanizing impact of doing face-to-face interviews that strip away the anonymity from the term “homeless.” Not only does it tap the intrinsic motivation among volunteers and people in agencies, but it enables service providers to match solutions to specific needs, rather than seeing if people are “eligible” for their programs.

Prioritize housing based on vulnerability, not worthiness. Those who are in positions to offer housing often have to choose who gets it first. It’s a hard choice. It’s tempting to favor sympathetic individuals who are making an effort to get back on their feet. But chronic homelessness can be thought of as a public health emergency. If we ask what hospitals would do, the answer is clear: give priority to the most severe cases, the people who are most likely to die soonest if they don’t get help.

Even when resources are scarce, there is room for improvement. Many communities that have sped up their housing placement rates are suffering from acute shortages of affordable housing. Even so, they have found opportunities to optimize their housing stock by rededicating scarce units to people who would be unable to find housing themselves. Also, by regularly communicating with colleagues in other agencies, they also discover loopholes and hidden pockets of funding.

Identify the bright spots and share the knowledge. One key advantage of the practice-based network that has been built through the 100,000 Homes Campaign is that it can quickly identify where a community has begun to move the needle and find out how it has done it. That information can then be disseminated to other communities facing similar problems to accelerate system-wide innovation.